1. Field of the Invention
The invention is related to a method, instrumentation, and treatments which use the onset of platelet contractile force (PCF) as a surrogate marker thrombin generation.
2. Description of the Prior Art
Thrombin generation is increasingly recognized as the critical component of normal hemostatic function. If thrombin formation is delayed as in various clotting factor deficiencies the individual is at risk for excessive bleeding. If thrombin generation is too rapid or incompletely controlled, as in thrombophilic states, the patient is at risk for recurrent thrombosis. Therapeutic interventions in both cases are geared at reversing abnormal thrombin generation either by speeding it up with hemostatic agents or slowing it down with anticoagulants.
Routine coagulation screens such as the prothrombin and partial thromboplastin time use fibrin formation as a surrogate marker of thrombin generation. Unfortunately, these studies are routinely performed in platelet poor plasma and thereby miss the potential effects of cellular elements on the rate of thrombin formation. The critical role played by tissue bearing cells and activated platelets is increasingly recognized (1,2). The continuing development of potent antiplatelet and anticoagulant agents and their combined application in settings such as acute coronary syndromes and cerebrovascular attacks have emphasized the need for a global measure of thrombin generation which could reflect the combined effects of these agents.